Suspected scaphoid fractures. The value of radiographs.
Twenty observers reported independently on the presence or absence of a fracture of the scaphoid on 60 sets of radiographs; these included initial and 2- to 3-week views in patients in whom the outcome was known, normal scaphoids and random copies of these. Analysis of variance of the accuracy of observations revealed that the 2- to 3-week radiographs did not improve diagnostic ability and that this was independent of the experience or seniority of the observer. For normal radiographs, 20% of the observations reported a fracture. Reproducibility of opinion improved with experience but this did not help with accuracy. Radiographs without accurate clinical observation should not determine the management of the suspected scaphoid fracture.
Dias
J J
JJ
Glenfield General Hospital, Leicester, England.
Thompson
J
J
Barton
N J
NJ
Gregg
P J
PJ
D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D015588:Observer Variation; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D013997:Time Factors